Hypothalamic hamartomas are often associated with early onset gelastic seizures, precocious puberty, behavioral problem and suboptimal response to antiepiletptic drugs. Until now, four surgical options have been reported to reduce seizure by >50%. Surgical excision have good seizure outcome but postoperative complications were not infrequent, whether by pterional or transcallosal interforniceal approach. Radiosurgery is noninvasive alternative to resective surgery but the effect usually does not appear until several months later. Radiofrequency ablation is less invasive than surgical resection and its effect is immediate, but lacks long term follow-up data. It also requires three dimensional analysis of the lesion to enhance effi cacy and safety. As hypothalamic hamartoma is intrinsically epileptogenic and epileptogenic discharges spread from the lesion, blocking the seizure propagation through endoscopic disconnection is regarded as an effective and safer option. Surgical choice for a particular patient should take into account the hamartoma’s size, location, surgeon’s preferences, possible complication as well as the effect and risk of the various surgical methods. In the present review, open surgery, endoscopic disconnection, radiosurgery and radiofrequency ablation are discussed.

In 1941 Wiberg discribed morphologic classification of patella in axial plane and the correlationship between its shape and dysfunction. Here the authors reviewed 120 cases and divided them into four groups. Group I is the one with no knee joint pain or patella dysfunction, group II is the patients with meniscus injury, gruop III is the patients with chondromalacia of patella and group IV is the patients with osteoarthritis of knee joint. We analysed them according to the ratio between the length of the patella and the articular surface in lateral X-ray films of patella. The results were as follows:1. The ratio between the length of the patella and the articular surface is 1.45±0.13(mean±SD) in group I, 1.47±0.18 in group II, 1.56±0.12 in group lll and 1.57±0.15 in group IV. 2. Statistically(P<0.05), no significant difference between group I and group II, but group III and group IV is significantly different from the group I. 3. The ratio between the length of the patella and the articular surface is thought to be helpful for diagnosing the patient with vague knee joint pain.
Cartilage Diseases ; Classification ; Humans ; Joints ; Knee Joint ; Osteoarthritis, Knee ; Patella ; X-Ray Film

The various methods of treatment of the supracondylar fractures of the femur were adapted by many authors according to degree of the involvement of the articular surface, displacement of fragments, degree of comminution and external forces. Authors experienced the supracondylar fracture of the femur in 31 cases who were treated at Koryo General Hospital from March 1984 until March 1988 and among them, 14 cases were treated by operative methods and 17 cases by conservative methods. The results were as follows:1. The male was more common, and the 3rd & 4th decades were most. 2. The most common cause of injuries was traffic accident. 3. The most common fracture type was type I by Neer's classification. 4. The type I was treated mostly by conservative methods and the type II & III by operative methods. 5. In the operative treatments, after anatomical reduction and rigid fixation, the duration of the rehabilitation was shortened by using the C.P.M. exerciser. 6. The complications were partial ankylosis of the knee, chronic osteomyelitis, nonunion and delayed union.
Accidents, Traffic ; Ankylosis ; Classification ; Clinical Study ; Femur ; Hospitals, General ; Humans ; Knee ; Male ; Osteomyelitis ; Rehabilitation

No abstract available.

No abstract available.
Mesothelioma* ; Pleura*

BACKGROUND: The cell mediated immunity has an important role in the pathogenesis of tuberculosis. sIL-2R has been known as a sensitive marker of T lymphocyte activation. Elevated serum levels of sIL-2R have been found in patients with lymphoproliferative disorders, organ transplantation, autoimmune diseases, and various granulomatous diseases. Elevated levels of sIL-2R have been also found in the seam and pleural fluid of the patients with tuberculosis. To evaluate the diagnostic value of sIL-2R in the differentiation of tuberculous pleurisy and. nontuberculous pleurisy. We measured the level of sIL-2R in the sera and pleural fluids of 12 patients with tuberculous pleurisy and 32 patients with nontuberculous pleurisy. METHOD: Samples of pleural fluid and serum were centrifuged at 2500 rpm for 10 min to remove cell pellets. Soluble R-2R was measured with a sandwitch enzyme immunoassay using the Cellfree r Interleukin-2 Receptor Test kit( T-cell science, Inc. Cambridge, MA). RESULTS: The results obtained were as follows: 1) The sIL-2R level in pleural fluid of the patients with tuberculous pleurisy was higher than that of patients with nontuberculous pleurisy(P<0.005). 2) When the sIL-2R level above 5,000 u/ml in pleural fluid was used as the cut-off value to diagnose tuberculous pleurisy, it had a sensitivity of 84.6% and a specificity of 90.9%. 3) The sIL-2R level in the sera of the patients with tuberculous pleurisy was higher than that of patients with bacterial pleural effusions and normal control group(P<0.05) and there was no difference of levels compared with malignant pleural effusions and transudative pleural effusions(P>0.05). 4) In patients with tuberculous pleurisy, the mean concentration of sIL-2R in pleural fluid was higher than that in serum(P<0.005). CONCLUSION: These findings suggest that the measurement of elevated levels of pleural fluid sIL-2R in tuberculous pleurisy may be useful in the differential diagnosis between patients with tuberculous pleurisy and nontuberculous pleurisy.
Autoimmune Diseases ; Diagnosis, Differential ; Humans ; Immunity, Cellular ; Immunoenzyme Techniques ; Interleukin-2* ; Lymphocyte Activation ; Lymphoproliferative Disorders ; Organ Transplantation ; Pleural Effusion ; Pleural Effusion, Malignant ; Pleurisy* ; Sensitivity and Specificity ; T-Lymphocytes ; Transplants ; Tuberculosis ; Tuberculosis, Pleural*

Acquired nasolacrimal duct obstruction may result from chronic infection, lacrimal stones, anatomical variations such as aberrant ethmoid cells, facial fractures, or complications following nasal surgery. In Korea, there has been no reported case of secondary nasolacrimal duct obstruction due to a retention cyst in the lacrimal sac. Recently, the authors encountered a 65-year-old female patient who presented with epiphora, was diagnosed with a lacrimal sac retention cyst, and was successfully treated with endoscopic marsupialization.

No abstract available.
Lung Neoplasms* ; Lung*

Abdominal tuberculosis is a rare disease, about 5% of extra-pulmonary tuberculosis. However, the diagnosis of abdominal tuberculosis is difficult, because of its atypical symptoms and signs, and ambiguous results upon physical examination. When abdominal tuberculosis is combined with abdominal injury, the diagnosis will be especially complex. We present our experience of abdominal tuberculosis associated with abdominal trauma.
Abdomen ; Abdominal Injuries ; Diagnosis ; Physical Examination ; Rare Diseases ; Tuberculosis*

Sarcomatoid carcinomas are malignant epithelial neoplasms in which the tumor cells assume a partial or complete spindle cell pattern of growth, leading to the erroneous classification of some true carcinomas as sarcomas. These spindle cells are malignant and manifest various amount of both vimentin and cytokeratin. Positive reaction of some of the spindle cells for cytokeratin antibodies is confirmatory. Clinical features do not differ significantly from those of patients with high-grade transitional cell carcinoma. So far, 13 cases of sarcomatoid transitional cell carcinoma of the renal pelvis have been reported in English and Korean literature. In this report, we describe clinicopathologic features of recently observed two cases of sarcomatoid transitional cell carcinoma of the renal pelvis and summarize the pathologic findings of previously reported cases with review of the literature.
Antibodies ; Carcinoma ; Carcinoma, Transitional Cell* ; Carcinosarcoma ; Classification ; Humans ; Keratins ; Kidney Pelvis* ; Sarcoma ; Vimentin